[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Laxatives](https://durgical.com/en/pharmacology/classes/laxatives/) › Plecanatide

# Plecanatide

## Laxatives?

Laxatives

A uroguanylin-like peptide that stimulates guanylate cyclase C in the gut, adding fluid to stool. Used for chronic constipation and IBS-C in adults.

Updated Nov 1, 2026

## Quick facts

**Group**
[Laxatives](https://durgical.com/en/pharmacology/classes/laxatives/)

**Target**
Guanylate cyclase C (GC-C) on intestinal epithelium

**Used for**
Chronic idiopathic constipation

**Key effects**
Diarrhoea · Bloating · Nausea

**Monitor**
Stool frequency and consistency · Signs of dehydration

**ATC**
A06AX07

No doses: the clinician sets them by the current guideline.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## Mechanism of action

Plecanatide is a synthetic analogue of uroguanylin. It activates guanylate cyclase C on the luminal surface of intestinal cells, raising cyclic GMP. This drives chloride and bicarbonate secretion into the lumen (through CFTR), water follows, stool softens and transit speeds up.

- Plecanatide activates guanylate cyclase C
- Cyclic GMP rises in enterocytes
- Chloride and water move into the lumen
- Softer stool, faster transit

## Indications

- Chronic idiopathic constipation in adults
- Irritable bowel syndrome with constipation in adults [Irritable bowel syndrome →](https://durgical.com/en/conditions/irritable-bowel-syndrome/)

## Adverse effects

### Common

- Diarrhoea, the most common effect
- Bloating, gas, abdominal tenderness
- Nausea, dizziness

### Serious (rare, important)

- Severe diarrhoea with dehydration
- Serious dehydration in young children (boxed warning)

## Contraindications

- Children under 6 years
- Known or suspected mechanical GI obstruction
- Avoided in patients under 18

## Key interactions

**Other laxatives or drugs that cause diarrhoea**
More diarrhoea and dehydration risk

## What is monitored

- Stool frequency and consistency
- Signs of dehydration with severe diarrhoea

## Administration and safety

- Oral tablet, with or without food; swallowed whole, or crushed and mixed only with water or applesauce if swallowing is hard, then taken at once.
- Kept away from children; accidental use by a child is an emergency risk.

## Pregnancy and breastfeeding

Human data are limited; it is used in pregnancy only if the benefit justifies the risk.

## Nursing care

- Confirm the patient is an adult and has no bowel obstruction.
- Teach to stop and call for severe diarrhoea.
- Teach to store it out of reach of children.
- Give and explain the medication guide.

## Pharmacokinetics

**Absorption**
Acts on the luminal surface of the gut lining

## Memory aid

«PLEcanatide PLEases the gut with water»: GC-C on, cGMP up, chloride and water out.

## Test yourself

Think of the answer, then tap the question to see it.

## Which enzyme does plecanatide activate?

Guanylate cyclase C on intestinal epithelial cells.

## Which natural peptide does it mimic?

Uroguanylin.

## Why is it contraindicated in young children?

Risk of serious, life-threatening dehydration.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/plecanatide/)

[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## Connections

## Related drugs 3

- [Linaclotide](https://durgical.com/en/pharmacology/linaclotide/)
- [Lubiprostone](https://durgical.com/en/pharmacology/lubiprostone/)
- [Prucalopride](https://durgical.com/en/pharmacology/prucalopride/)

## Related conditions 1

- [Irritable bowel syndrome](https://durgical.com/en/conditions/irritable-bowel-syndrome/)

[← Back to the class: Laxatives](https://durgical.com/en/pharmacology/classes/laxatives/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Plecanatide: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a617020.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=A06AX07) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/plecanatide/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/plecanatide/